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NPI Code Detail

MEDICARE: DANIEL VISSER RPT

MEDICARE: DANIEL VISSER RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2732SC

General Provider Information

NPI Number : 1881652485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL VISSER RPT
Provider Business Mailing Address
First Line : 8811 WARREN H ABERNATHY HWY
Second Line :
City : SPARTANBURG
State : SC
Zip : 29301-1228
Country : US
Telephone Number : 864-574-7282
Fax Number : 864-574-7664
Provider Business Practice Location Address
First Line : 2500 WINCHESTER PL
Second Line : SUITE 100
City : SPARTANBURG
State : SC
Zip : 29301-1550
Country : US
Telephone Number : 864-574-7282
Fax Number : 864-574-7664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 01/25/2021

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